Four A&E units in north-west London recommended to close
Four A&E departments in north-west London have been recommended to close.
The departments in Ealing, Central Middlesex, Charing Cross and Hammersmith hospitals could be downgraded to 24/7 urgent care centres.
NHS North West London says it wants to replace them with community facilities which would improve patient care.
Opponents have said the plans to create "centres of excellence" would pit "hospitals against hospital".
The recommendations are based on "major hospitals" offering 24/7 A&E units and being able to do both emergency and elective operations; have intensive care units, psychiatric liaison, inpatient paediatrics and a maternity unit.
The major hospitals would be Chelsea and Westminster, Hillingdon, Northwick Park, St Mary's and West Middlesex.
The hospitals losing their A&E units will be known as "local hospitals" and instead offer 24/7 urgent care centres as well as outpatient and diagnostic services.
The trust said by operating five "major hospitals", there would be more specialist and experienced doctors available more of the time.
Dr Mark Spencer, medical director of North West London NHS, said: "I have no doubts at all that the care we will be providing will be better than it is currently.
"First, we're investing a lot in community services so more people who currently go to hospital will have care closer to them, their GP surgery or right at home, so they won't need a hospital at all.
"Most things will still happen at a hospital if they go to outpatients, they will still continue to go there; if they want an x-ray or a scan that will still happen in their local hospital."
Councillor Julian Bell, Labour leader of Ealing Council, said: "We will look to refer it to the secretary of state for health through our scrutiny committee and we'll also keep all our legal options open to challenge it through a judicial review."
Five specialist hospitals in the area, Harefield, Mount Vernon, Royal Brompton, Royal Marsden and Royal National Orthopaedic Hospital, are not affected by the proposals.
The recommendations are to be formally decided on at a joint committee of primary care trusts on Tuesday.